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TOP QUALITY Dental Implant Restoration Ca
Maintenance of Full-Arch Implant Restorations
Replacement of the terminal dentition with a full-arch, fixed dental implant restoration is well accepted as an effective treatment alternative. The quantity of implants placed, axial or tilted inclination, and fixture positioning, varies, however the full-arch implant foundation has been shown to become a successful modality in supporting a dental rehabilitation.

dental implant restoration ca of this restoration is its prosthetic design. Whenever you can, screw retention of the restoration is desirable to be able to manage mechanical as well as biological complications after delivery and through the maintenance phase. The full-arch, screw-retained implant restoration can be fabricated in multiple compositions like the following: cast metal framework overlaid in denture acrylic materials, milled titanium framework overlaid in composite resin, milled zirconia with or without feldspathic porcelain overlay, or porcelain-fused-to-ceramic alloy substructure. All have their individual benefits and drawbacks, but all can provide excellent comfort, function, and esthetics. Adequate oral hygiene ensures successful maintenance, with plaque control paramount for reduction of inflammation, limitation of pathogenic oral bacteria, and prevention of stains and odors.


While patients must take responsibility for personal hygiene, the dentist must assume a cooperative responsibility when fabricating this complex restoration. Emergence profile of the prosthesis off the implant/abutment platform will need to have hygienic contours, and the inter-implant pontic sections ought to be self-cleansable and designed commensurate with standard prosthodontic guidelines. If dentist sunset district san francisco are met, and the patient practices responsible home care in conjunction with professional recall maintenance, success of the rehabilitation can be expected.

Prevention of biological complications is of utmost importance for the long-term survival of dental implants. Biological complications that may be encountered could be either peri-mucositis, which is a reversible inflammatory process in the soft tissues, or peri-implantitis that involves a concomitant lack of peri-implant bone.1 Professional maintenance protocol will include a review of changes in medical history and a comprehensive evaluation of the soft tissues surrounding the implants for inflammation signs such as for example redness, swelling, change in probing depths, bleeding on probing, and suppuration.2 Furthermore, the current presence of plaque and calculus should be assessed. Clinicians must have baseline probing depths and radiographs following the delivery of the ultimate superstructures for comparison.3 Baseline probing depths should be measured within approximately 14 days after delivery to permit for peri?implant soft tissue healing. Probing under fixed implant-supported prostheses can be challenging at times, particularly in maxillary sites imposed by the nature of the prosthetic design. In such cases, it is recommended that a minumum of one surface be identified where proper probing can be performed.4

Radiographs should be retaken once every one to two 2 years thereafter, or when there are any signs of infection. The significance of oral self-care practices and a long-term professional recall regimen should be emphasized at every visit. Clinicians should ensure that their patients can perform the required skills. Brushing at least twice daily, use of floss, interdental cleaners, and water irrigator is preferred.

Management protocols for patients with mucositis or at risk for development of peri-implant disease can include usage of antiseptic mouth rinses which might improve soft tissues and microbial outcomes around implants. Removal of a set, screw-retained implant prosthesis for evaluation isn't needed unless you can find signs of peri-implantitis, a demonstrated inability to maintain adequate oral hygiene, or there are mechanical complications that want removal.5 You should remove calculus safely with cleaning instruments compatible with the material of the implants and superstructures. Ultrasonic devices with plastic tips or rubber cup and low-abrasive polishing paste may be used. In-office implant maintenance appointments at 2- to 6-month intervals ought to be scheduled and predicated on a patient?s risk profile (e.g., history of smoking, history of periodontitis, systemic conditions, patient?s limited vision and dexterity, etc.).6

The mechanical areas of recall for full-arch fixed restorations focus on interface stability between the restoration and supporting intermediate abutments or implants. The stability of these interfaces is predicated upon two mechanical factors: passive fit of the restoration and proper assembly techniques at delivery.7 Passive fit is thoroughly evaluated at delivery, but generally confirmed in a recall scenario with radiographs. If the restoration or any supporting components aren't fully seated, the restoration will be removed, evaluated, and perhaps re-made to attain the prerequisite of passive fit.

The next mechanical factor may be the assembly method at delivery. The critical elements include torque level, screw coatings, the pattern of tightening, another torque application to overcome the initial mechanisms of screw relaxation.8 Once this assembly is complete, subsequent tightening of screws at recall visits is inappropriate and may lead to diminished interface stability from excessive screw elongation.9 If the restoration is in function and free of mechanical complications, there is no indication for removal and/or replacement of screws. When applied loads to the restoration are controlled, an adequately assembled interface will remain stable as time passes.9

If the restoration acquires a history of screw loosening or screw fracture, the etiology of the complications ought to be identified and addressed. The frequent replacement of screws to avoid complications can lead to more serious mechanical complications, such as implant fracture.10 Whenever a restoration must be removed, the usage of new screws assists in achieving ideal assembly conditions for stable interfaces.5,8

Based upon the present literature, it's the position of the American College of Prosthodontists that removal of full-arch, implant-supported restorations at regular maintenance intervals is discouraged unless adequate professional hygiene isn't possible with the superstructure in place or the restoration presents with mechanical complications.

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